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'Bad' cholesterol levels down in adults

A study credits statin drugs, but also notes that many people remain at risk and are not being treated.

November 18, 2009|Shari Roan

Levels of LDL, or "bad," cholesterol fell by about a third from 1999 to 2006 among American adults, a study has found -- probably because of the influence of statin drugs on blood lipid levels.

However, a large number of people still have excessively high levels of LDL cholesterol, are not being treated for it, and may even be unaware of their levels, the study also found.

The report, published in the Journal of the American Medical Assn., examined LDL cholesterol levels among more than 7,000 men and women across four study cycles: 1999-2000, 2001-2002, 2003-2004 and 2005-2006.

Rates of high LDL cholesterol decreased from 31.5% in 1999-2000 to 21.2% in 2005-2006, according the Centers for Disease Control and Prevention's Dr. Elena V. Kuklina and colleagues. That still leaves many people in the U.S. population with elevated rates of bad cholesterol.

Fewer than 70% of adults nationwide were screened for cholesterol levels in the 2005-2006 period.

During that period, 64.5% of people in the study group received cholesterol screening; 39.6% were screened but were untreated or inadequately treated; and 24.9% were not told the results of screening.

In a commentary accompanying the study, two Boston physicians said that cholesterol screening guidelines had become too complex and should be simplified so that more people receive the treatment they need.

Dr. J. Michael Gaziano of the Massachusetts Veterans Epidemiology Research and Information Center and Dr. Thomas A. Gaziano of Harvard and Brigham and Women's Hospital noted that the last set of cholesterol guidelines, published in 2002, was 280 pages.

The guidelines are not only complicated, they are far from perfect, the two doctors added. That sometimes leads doctors to prescribe statins to people who have elevated LDL cholesterol but an overall low risk of heart disease, or to not prescribe drugs to people with normal LDL cholesterol but with a high overall risk of developing heart disease because of other factors such as diabetes or high blood pressure.

Arbitrary, fixed LDL thresholds for prescribing statins should be abandoned, the two doctors wrote. Instead, physicians should use a risk assessment tool that would divide people into two simple groups: those for whom lipid-lowering therapy should be considered and those for whom it is not warranted.

--

shari.roan@latimes.com

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